Characteristics of Pediatric Frequent Users of Emergency Departments in Alberta and Ontario
Autor: | Andrew D McRae, Maria B. Ospina, Patrick McLane, Antonia S Stang, Anqi Chen, Rhonda J. Rosychuk |
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Rok vydání: | 2021 |
Předmět: |
Male
Ontario business.industry Psychological intervention General Medicine Odds ratio Emergency department Logistic regression Mental health Confidence interval Alberta Logistic Models Ambulatory care Pediatrics Perinatology and Child Health Health care Emergency Medicine Odds Ratio Medicine Humans Female business Child Emergency Service Hospital Demography Retrospective Studies |
Zdroj: | Pediatric emergency care. 38(3) |
ISSN: | 1535-1815 |
Popis: | Objectives Emergency department (ED) volumes have drawn attention to frequent users but less attention has been paid to children. This study examined sociodemographic and ED presentation characteristics of pediatric high-system ED users (HSUs) in 2 provinces in Canada. Methods Cohorts of HSUs were created from the National Ambulatory Care Reporting System in 2015/2016 for children with the top 10% of ED presentations. Controls were random samples of non-HSU patients. Factors were explored in multivariable logistic regression models. Results There were 151,497 HSUs (51.7% girls, average age, 6.4 years) and 591,545 controls (53.1% girls; average age, 7.4 years). High-system ED users were more likely to be younger (adjusted odds ratio [aOR], 0.89 per 5 years; 95% confidence interval [CI], 0.88-0.89), live in less populated areas (aOR, 1.85; 95% CI, 1.82-1.88), and from lowest income neighborhoods (aOR, 1.51; 95% CI, 1.48-1.54) than controls. High-system ED users had higher proportions of presentations for pediatric complex chronic (aOR, 1.25 per 0.25 increase; 95% CI, 1.21-1.29), respiratory (aOR, 1.14 per 0.25; 95% CI, 1.12-1.15), and mental health (aOR, 1.14 per 0.25; 95% CI, 1.13-1.16) conditions than controls. Conclusions Complex factors underlie pediatric health care utilization decisions. Findings identified conditions to target in interventions to improve health care access and utilization. Future work should engage children and families to design interventions. |
Databáze: | OpenAIRE |
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